Evaluating School‐Based Substance Use Services: Insights From a Systematic Review

Background Substance use among youth can have lifelong consequences and therefore requires early and targeted services for those at risk. Schools possess a unique opportunity to provide substance use services to youth for both prevention and intervention. However, limited research exists on the school‐based substance use services and their effectiveness. Methods Using PRISMA guidelines, online databases were searched for studies done between 2004 and 2024 on school‐based substance use services, their outcomes, and the characteristics of those administering them. Findings Results showed school‐based substance use services being offered in multiple settings. Screening and intervention were the most common services provided. Although specific outcomes varied by study, including academic performance, perceptions, and actions, most were positive. Implications for School Health Policy, Practice, and Equity Schools should create strategic plans for feasible and sustainable substance use services. Use of the screening, brief intervention, and referral to treatment (SBIRT) framework can be used to organize these efforts. Establishing robust referral networks is of particular importance for schools. Conclusions This review highlights opportunities for schools to focus on screening and brief intervention for in‐school services while also building a strong referral network for times when treatment is necessary.